Developing confidence keeps breast cancer survivors exercising

Breast cancer survivors who develop such behavioral skills as self-confidence and motivation are much more likely to continue exercising on their own after leaving a supervised exercise program. Otherwise, more than 40% of older breast cancer survivors are not active enough after they leave a supervised program.

Regular exercise may reduce the risk of breast cancer recurrence and breast cancer-related mortality. These risk reductions make it crucial to develop effective ways to intervene with those breast cancer survivors who do not regularly engage in physical activity.

A clinical trial was conducted by researchers at Oregon State University and Oregon Health and Science University to understand the benefits of a 12-month supervised exercise program in 69 breast cancer survivors age 65 years and older. The researchers sought to discover what factors influenced the ability of participants to follow through and continue exercising after the supervised program ended.

Those breast cancer survivors who had higher self-efficacy, or confidence to overcome such exercise-related barriers as being too tired, were much more likely to continue exercising on their own. The participants with higher self-efficacy were 10% more likely to be physically active 6 months after the intervention than those with lower self-efficacy scores.

The lead author of the study, Paul Loprinzi, PhD, explained that the good news is that behavioral skills to increase self-efficacy can be taught. He explained, “We can teach breast cancer survivors how to enlist the support of others and how to identify exercise-related barriers, as well as provide proven strategies for them to overcome those barriers.”

Meeting physical activity guidelines is crucial for breast cancer survivors. Exercise helps to reduce common side effects of cancer that include fatigue, depression, decreased muscular strength, and weight gain. “Especially important is minimizing weight gain after breast cancer treatment because excessive weight gain can increase the risk of developing recurring breast cancer,” stated Loprinzi.

Modeling behavior by instructors who administer supervised exercise program for breast cancer survivors can help. Study co-author Brad Cardinal, PhD, explained, “When people who lead the classes are cancer survivors themselves, this can help because they become a role model.”

Cardinal also suggested counter-conditioning, which is substituting a positive behavior for a problem behavior, such as taking a walk whenever feeling stressed. Having a network of friends, family, or providers who provide encouragement and support is also a factor that helps people to stick with exercise.

Further, Cardinal stated that he would like to see policy makers address the issue of support for cancer survivors. He said, “We know survivors of breast cancer are much more likely to stick with exercise if they have that structured, group support. Ideally, it would be great if insurance programs provided for that post-treatment supervised exercise longer than 1 year. But in lieu of that, we can help them build the skills to continue on their own successfully.”

This study by Loprinzi and colleagues was published in Supportive Care in Cancer (2012;10:2511-2521).
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